Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter J - PURCHASED HEALTH SERVICES
Division 30 - FAMILY PLANNING
Section 355.8581 - Reimbursement Methodology for Family Planning Services
Universal Citation: 1 TX Admin Code ยง 355.8581
Current through Reg. 49, No. 38; September 20, 2024
(a) Family planning services described in 25 TAC Chapter 56 (relating to Family Planning) are reimbursed as follows:
(1) For physician and other practitioner
services, physician-administered drugs and biologicals, and the administration
of immunizations, providers are reimbursed the lesser of:
(A) the provider's billed charges;
or
(B) fees determined by the Texas
Health and Human Services Commission in accordance with §
RSA
355.8085 of this subchapter (relating to
Reimbursement Methodology for Physicians and Other
Practitioners).
(2)
Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) are
reimbursed in accordance with § 355.8023 of this subchapter (relating to
Reimbursement Methodology for Durable Medical Equipment, Prosthetics, Orthotics
and Supplies (DMEPOS)).
(b) Fees for family planning services and items are adjusted within available funding as described in § RSA 355.201 of this title (relating to Establishment and Adjustment of Reimbursement Rates by the Health and Human Services Commission)
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